Pharmacy is no longer considered simply as the science and technique of preparing and dispensing drugs and medicines. In this modern day, pharmacists are no longer considered “pill counters.” Contemporary pharmacy practice reflects an evolving paradigm from one in which the pharmacist primarily supervises medication distribution and counsels patients, to a more expanded and team-based clinical role providing patient-centered medication therapy management, health improvement, and disease prevention services.1
For decades, in Latin American countries the pharmacist has been seen as “The Doctor” of the community and the patients consult the pharmacist for all of their health and wellness needs, including medication therapy prior to initiating a drug regimen and throughout the course of therapy. We are seeing a familiar shift in the United States as pharmacists are taking on a more clinical versus dispensing role.1
Health and wellness, as defined by the World Health Organization, is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.2 Many employer groups have developed health and wellness programs within the workplace in an effort to support a healthy workforce while decreasing overall healthcare costs.
According to a 2008 survey by Hewitt Associates, approximately 93% of US employers have some type of wellness program instilled within their institution.3
Over the past several years, we have seen drastic annual increases in healthcare costs for Americans with a decrease in health benefits and care.4 The skyrocketing healthcare costs have been a major concern for US employers and several organizations, including the National Business Group on Health, which is working on reasonable solutions to improve quality and safety while decreasing cost challenges.5 Similarly, it is important to educate policymakers and legislators on how these issues impact employer-sponsored care and today’s workforce.
Pharmacists Play a Key Role in Health and Wellness
As pharmacists, we play a key role in providing an important piece of the puzzle regarding the health and wellness of our patients. There are 8 key components of wellness6: social wellness, physical wellness, environmental wellness, emotional/mental wellness, intellectual wellness, career/livelihood, spiritual wellness, and financial wellness.
Pharmacists today are capable of supporting several of these key components by providing a broad spectrum of services, including health and wellness screenings, chronic disease management, immunizations, and medication therapy management.7
Retail pharmacists have solidified their roles within the healthcare team by being one of the most highly accessible healthcare providers in the community and assisting their patients in maintaining continuity of care by educating patients on disease management (ie, Certified Diabetes Educator), chronic therapy management, administering immunizations, and narrowing the communication gap between physicians and patients. In doing so, the retail pharmacist is assisting in the new healthcare reform by improving healthcare outcomes in patients and lowering overall healthcare costs.
Embracing an Expanding Role
With managed care organizations and physicians being forced to focus more on patient adherence and overall outcome, pharmacists will continue to play a critical role within the healthcare team––paving the way for pharmacists to spend more clinical time reviewing, managing, and supporting the overall wellness and outcome of patients.
Pharmacists in the retail setting should embrace this opportunity bestowed upon them and prove to any skeptics that they are no longer considered “pill counters.” Pharmacists are now members of the healthcare team and are a key component between patient and physician in improving the overall health and wellness of the patient.
Numerous community-based initiatives have demonstrated that retail pharmacists providing services, such as intensive education and ensuring patients are using their medications correctly, can contribute to improved patient outcomes and lower total healthcare costs. With the support of a “pharmacist health-coach,” patients can become effective at self-managing a chronic disease.8-10
Several studies have shown the importance of pharmacist-provided patient care services. The Asheville Project began in 1996 as an effort by a self-insured employer to provide education and personal oversight for employees with chronic health problems such as diabetes, asthma, hypertension, and high cholesterol. During a 6-year period, cardiovascular and cerebrovascular (cardiovascular collectively) medication use increased nearly 3-fold, and cardiovascular-related medical costs decreased by 46.5%.9
The Diabetes Ten City Challenge was launched in 2005, involving employers in 10 distinct geographic locations in the United States.10 Using incentives, employers encouraged people to manage their diabetes with the help of pharmacist coaches, physicians, and community health resources. Results to date indicate that this collaborative approach results in (1) savings of approximately $918 per employee in total healthcare costs for the initial year, with even greater savings in subsequent years; (2) return on investment of at least 4:1 beginning in the second year; (3) a 50% reduction in absenteeism and fewer workers’ compensation claims; (4) high employee satisfaction (95% approval for pharmacist care) and improved quality of life; and (5) employees saving an average of $400 to $600 per year with incentives such as waived copays.10
Overall, the contributions of retail pharmacists have positively contributed to health and wellness as demonstrated by The Asheville Project and the Diabetes Ten City Challenge. These studies exemplify why pharmacist-provided patient-care services are an asset not only to the patient, but to overall healthcare in the United States.9,10 The studies showed that pharmacist intervention was associated with increased access to and adherence with prescription drug therapies, reduced medication errors and other harms, improved outcomes, and reduced costs.
Because of the high priority of health and wellness in today’s society, retail pharmacists are capable of providing the broad spectrum of services. In doing so, retail pharmacists are assisting in the healthcare reform by reducing hospital readmissions, improving healthcare outcomes in patients, lowering overall healthcare costs, and increasing prescription counts.
- Hritcko PM. A new paradigm for pharmacy practice and education. Harvard Health Policy Review. 2006;7(1):143-146.
- World Health Organization. WHO definition of health. www.who.int/about/definition/en/print.html. Accessed June 4, 2014.
- The Incentive Research Foundation Resource Center. Energizing Workplace Wellness Programs: The Role of Incentives and Recognition. http://theirf.org/research/content/6078727/energizing-workplace-wellness-programs-the-role-of-incentives-and-recognition/. Accessed June 4, 2014.
- America’s Health Insurance Plans. Rising health care costs. www.ahip.org/Issues/Rising-Health-Care-Costs.aspx. Accessed June 4, 2014.
- National Business Group on Health. Cost solutions and benefits designs. www.businessgrouphealth.org/resources/csbd/index.cfm. Accessed June 4, 2014.
- Substance Abuse and Mental Health Services Administration. Eight dimensions of wellness: a holistic guide to whole-person wellness. www.promoteacceptance.samhsa.gov/10by10/dimensions.aspx. Accessed June 4, 2014.
- American Pharmacists Association. Medication therapy management services. www.pharmacist.com/medication-therapy-management-services. Accessed June 4, 2014.
- Garrett DG, Bluml BM. Patient self-management program for diabetes: first-year clinical, humanistic, and economic outcomes. J Am Pharm Assoc. 2005;45(2):130-137.
- Bunting BA, Smith BH, Sutherland SE. The Asheville Project: clinical and economic outcomes of a community-based long-term medication therapy management program for hypertension and dyslipidemia. J Am Pharm Assoc. 2008;48(1):23-31.
- Fera T, Bluml BM, Ellis WM. Diabetes Ten City Challenge: final economic and clinical results. J Am Pharm Assoc (2003). 2009;49:383-391.